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Memory Loss, Cognitive Problems Post-Surgery?

August 22nd, 2012, 12:28 PM

I have read about an alarming side-effect of OHS that seems to be rather scary, especially with me being a rather young person about to have my first heart surgery. I have read that at least half of those who undergo OHS have diminished brain function whether long or short-term, mainly because of the heart-lung machine, which can pump tiny bits of plastic and toxic chemicals into the body, blocking arteries in the brain. Has anyone had experiences with this or overcoming this? Do you know people this has happened to?

I had similar concerns about "pump head" before my first surgery. I've had open heart surgery two times and I have no cognitive deficit. I do forget things sometimes but I've always been a little absent-minded and I am 49 years old now :-) I can still help my kids with their math homework.

The problems you've read about are more common in older patients, can improve over time, and are not the norm. I believe some of the temporary cognitive symptoms some patients experience are probably also related to hours of general anesthesia during surgery and all the narcotic pain killers in the weeks after surgery. With my first surgery, my ascending aorta was repaired with a conduit. This required deep hypothermia and circulatory arrest for about 10 minutes (no heart beat and pump turned off). I believe the surgical team may have used retrograde perfusion to send oxygenated blood backwards through my brain and vital organs during circulatory arrest. Even with all that, I have no cognitive problems.

I just had my aortic valve replaced again 7 weeks ago and I feel back to normal. In fact, I feel better than before my surgery.

The internet can be a great place to educate yourself about what you're going through. You'll find lots of information including all the things that can sometimes go wrong. The problem is that we patients just don't have the years of experience to estimate the actual risks WE face. Talk openly with your cardiologist and surgeon about your concerns. They can help you keep everything in perspective and avoid overestimating the odds of a problem in your case.

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I have read that at least half of those who undergo OHS have diminished brain function whether long or short-term, mainly because of the heart-lung machine, which can pump tiny bits of plastic and toxic chemicals into the body, blocking arteries in the brain. Has anyone had experiences with this or overcoming this? Do you know people this has happened to?

Hi AceofHearts and welcome. I know this forum can help you separate "fiction from fact" regarding some of the stuff you may hear or read. For many, there is a short time post surgery that we may experience some brain fog and memory loss as our body overcomes the anesthesia and trauma of the event. I honestly do not recall any problems with brain function in any way. Huh?? "Tiny bits of plastic and toxic chemicals".......that's a new one. Stick around, we have some who send us E-mailes from their ICU....so I'm pretty sure they are very lucid, very quickly.

Starr-Edwards mechanical AVR 1967 at age 31.....University of Kentucky Med. Ctr., Drs. Richard Wood & Gordon Danielson surgeons. No surgery (heart or otherwise) since. On Warfarin ACT since surgery with no diet, lifestyle, or activity restrictions....and I live one day at a time.

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I'm six months out from having my AVR and I can honestly say that I've experienced no memory loss or problems concentrating. As a matter of fact, as soon as I woke up from surgery I was very lucid. I remembered what date it was, what time my surgery was and I gave my wife a hand signal I told her to look for to let her know that I was truely "all there" and not just a shell answering yes or no questions. BTW, the hand signal was the ol' "Hang loose" sign. (we thought it would be funny).

I had a bicsupid aortic valve that was not discovered until I was 30 years old.
Aortic valve and aortic root replacement via Bentall Procedure on March 5, 2012. Surgery was performed by Dr. Lynn McGrath at Deborah Heart and Lung Center in New Jersey.

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I didn't have any memory issues either and was told that the newer pumps are easier on the brain. Anesthesia and hard core pain meds DO mess with my brain (among other things), so I got off them as quickly as possible. My biggest "cognitive" type issue was a lack of mental focus that lasted for a few weeks or so. I attribute that more to the shock of what my body had been through than the pump.

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There was a study done at Duke or maybe UNC that estimated that something like 40% of OHS patients felt that they had experienced some significant mental impairment, aka "pump-head". My info indicates that most of it is due to drugs rather than the bypass.

In my long "Norm's Story. . ." blog/thread, I tell of my various pre-op negotiations with my anaesthesiologist(s), which ended up with me getting an unusually low dose of benzodiazepines (a family of anti-anxiety meds that's known to cause retrograde amnesia) during my AVR/OHS. I woke up feeling quite cogent and "me", and have had no special mental impairment in the 21 months since. Can't say that I have a perfect memory or brain at 67yo, but it's not bad, and not noticeably worse since the OHS.

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I had my 4th heart surgery over 2 years ago. I am 46 years old. I have been on the heart/lung machine 3 times. After the last surgery I had a short period of time when I just could not think as fast as before. Now I am better than before surgery.

Debbie

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There's definitely been members here that mention they feel the surgery affected their memory significantly. However, I think if anything happened after surgery regarding memory and cognitive function for myself, it was an improvement. My mind definitely feels better for sure.

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I was solidly into middle age at time of surgery (was 63) and I was one of the ones on my cell phone sending email and reading the boards from the cardiac unit. And that's after some pretty scary complications and the implantation of a pacemaker. I don't notice any cognitive impairment, and in my job I would notice it if it was present. I am the Chief Financial Officer of a manufacturing company - not a job for those who crave a calm 9 to 5 existance. I'm doing better than I was before surgery -- no mental degradation beyond that which was present prior to surgery (I'm kidding again) and I have more stamina to keep at it all day.

I spoke with my anaesthesiologist about "pump-headedness" before surgery, then decided to tell them to just do their job the way they felt they needed to. No issues here, and as I mentioned before, I had all sorts of heart rhythm issues post-op. Almost all of us do just fine, and I would bet that you will, too.

Go Class of 2011!

Steve Epstein
9 Years in The Waiting Room, then on February 28, 2011,
AVR with 23mm Edwards Bovine Pericardial Tissue Valve, Model 3300TFX, Pacemaker - Boston Scientific Altrua 60 DDDR IS-1 and CABG (LIMA-LAD) at Northwestern Memorial Hospital, Chicago by Dr. Patrick McCarthy and the most wonderful team of professionals I could ask for.

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Wikipedia defines "pump head" asPostperfusion syndrome, also known as "pumphead" is a constellation of neurocognitive impairments attributed to cardiopulmonary bypass (CPB) during cardiac surgery. Symptoms of postperfusion syndrome are subtle and include defects associated with attention, concentration, short term memory, fine motor function, and speed of mental and motor responses.[1] Studies have shown a high incidence of neurocognitive deficit soon after surgery, but the deficits are often transient with no permanent neurological impairment.[1][2][/ For more on this see http://en.wikipedia.org/wiki/Postperfusion_syndrome in all that I have looked at it indicates it is temporary

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There is lots of information on here about "pump-head". I will weigh-in with my experience. It's been close to 5 month post-op, and I still remember first day post OHS as if it was last week. I can still add, subtract and multiply. Division is still a bit difficult... Just kidding! I spoke with my anesthesiologist at length about the condition and they assured me that even if it was to happen it reverses with time.

Still, there are some articles on here about "pump-head" with research attached, and I believe the good folks above have good weigh-in as well.

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Hi,
Pumphead was one of my big concerns, also, before surgery. For a good 6 months preop, I did not feel cognitively "sharp". I noticed almost immediately ( after anesthesia wore off) that the mental fog was lifted and it has not returned.